Podiatry

Foot care is frequently overlooked in people with intellectual and developmental disability (IDD), who may not be able to look after their own feet. Associated communication difficulties may also render people with IDD unable to communicate foot pain. Cerebral palsy is associated with limited mobility, foot and ankle deformity, muscular spasticity, poor peripheral circulation, and osteoporosis. Foot deformity and poor peripheral circulation contribute to pressure areas and foot ulcers, especially with co-morbidity such as diabetes, which is associated with increased risk of lower limb amputation and infection. Other co-morbidites may also affect children and adults with IDD, including arthritis and chromosomal anomalies. Basic foot problems such as ingrown nails can present increased clinical challenges, as can the use and fit of footwear. This chapter has contributions from many podiatrists, from both research and clinical settings, and covers issues that are condition-specific and also universal to all facets of foot health. Whilst not exhaustive, attempts are made to provide insight and information for application of podiatry care in the total management of people with IDD across the lifespan.